Patent Application Titled “Claim And Progression Management” Published Online (USPTO 20200090292)

2020 APR 07 (NewsRx) -- By a News Reporter-Staff News Editor at Health Policy and Law Daily -- According to news reporting originating from Washington, D.C., by NewsRx journalists, a patent application by the inventor LaVan, Kenneth L. (Plantation, FL), filed on November 19, 2019, was made available online on March 19, 2020.

The assignee for this patent application is Case Ghost Inc. (Plantation, Florida, United States).

Reporters obtained the following quote from the background information supplied by the inventors: “Government agencies have developed rules and regulations for applying for and receiving government benefits. These agencies also have developed rules and procedures for adjudication of disability requests. In particular, the Social Security Administration receives probably the most requests for retirement and disability benefits of all of the government agencies which pay out benefits. Medicare provides health insurance under Title XVIII of the Social Security act. Therefore, the Social Security Administration must process Medicare claims in addition to retirement claims. There is also the Social Security Disability Insurance program which handles disability claims and benefits for those individuals who qualify. Again, there are rules and procedures for the processing of these disability claims. There are businesses, in particular law firms that file for Social Security benefits on behalf of their clients. Currently, this is a very tedious, difficult, and time consuming process. This process becomes even more difficult when the conditions under which the initial benefit claim was made changes. For example, when a claim for a medical benefit has initially been made and there is a change in the medical condition of the claimant, different forms need to be completed and specific procedures need to be followed. Also, if a claim or claims for benefits have been denied, there are specific procedures that need to be followed to properly appeal the denial decision of the Social Security Administration or other government agencies.

“Thus, what is needed in the art is a process for filing benefit claims with the Social Security Administration, or other government agencies, which can follow the proper claim procedures to assure the claimant receives the benefits that he/she is entitled to. Also a process that will enable filing of updated and/or changes in status of benefits. Further, a process that will assure a proper and correct filing of an appeal for denial of certain benefits.”

In addition to obtaining background information on this patent application, NewsRx editors also obtained the inventor’s summary information for this patent application: “The present invention is a computer implemented method and system for gathering information from a user related to, filing for, and obtaining government benefits, such as Social Security benefits. The present invention also enables the user to track the benefit application approval process and reminders when certain data or responses are due. There is a feature which enables the user to modify the data submitted for the benefits when circumstances warrant. The system presents questions in a systematic method to reduce the time it takes to complete an intake. Based on answers provided, the intake wizards guides the user through appropriate questions to ask based on the previous answers provided. for example if the potential client is a veteran the intake will ask service related questions that can be evaluated for an SSA claim and/or VA claim. If an answer disqualifies the claimant from SSDI or SSI for a ‘technical’ reason, the questionnaire is terminated so that the user can move on to the next intake quickly and efficiently. If an answer does not disqualify the claimant from the intake process, the intake moves onto the next sections of the questionnaire. The system assists the user in computing what stage in the process the claimant is currently at. For example, Needs to File an Application, Initial Application, Denied Initial Claim, Reconsideration, Denied Reconsideration, Hearing Filed, Ready to Schedule a Hearing, Hearing Scheduled, Awaiting Decision, Appeals Council, or Federal Claim (many claimants get confused and this is an important part of the application process). Questions are presented related to the claimant’s medical history to determine if the user has a valid claim for benefits. The system may in certain instances medically approve the client for representation. When an intake is accepted, the intake wizard assigns the intake to a person responsible for getting the retainer signed, the intake system programmatically fills in SSA forms for the client to sign, emails the forms when appropriate, determines what SSA district office is assigned to the claimant, and then programmatically completes the three SSA Application forms when appropriate. There is also a decision appeal process feature.

“Accordingly, it is an objective of the present invention to provide a computer implemented method and system for inputting data into a government benefits system.

“It is a further objective of the present invention to provide an intake wizard which permits a user to automatically populate a form by input data related to obtaining government benefits, including medical conditions.

“It is yet another objective of the present invention to provide an intake wizard which assists a user in responding to denial of government benefits.

“It is a still further objective of the present invention to provide an import wizard which handles incoming mail, outgoing mail, workflow documents, medical records, document attachments, and collections.

“It is a still further objective of the present invention to provide an application wizard which enables a user to correction complete an application form for government benefits.

“It is a still further objective of the present invention to provide a computer implemented method and system which enables multiple individuals to file on behalf of multiple users for government benefits, maintain the records of these users and respond to different requests and/or information from a government agency regarding the application for the users’ benefits requests.

“Other objectives and advantages of this invention will become apparent from the following description taken in conjunction with any accompanying drawings wherein are set forth, by way of illustration and example, certain embodiments of this invention. Any drawings contained herein constitute a part of this specification and include exemplary embodiments of the present invention and illustrate various objects and features thereof.”

The claims supplied by the inventors are:

“1. A computer driven systematic method for filtering data regarding Social Security disability, Veteran’s Disability Compensation, or Workers Compensation claims, the method comprising the steps of: providing on-line accessible data fields via a questionnaire whereby data is entered on a computer device coupled to the Internet; providing a database that stores pre-configured rules in order to compare the data received via the questionnaire against such rules; receiving data that is entered into the questionnaire, by a computer device coupled to the internet, said computer device having a processor configured to execute a computer application to compare the data that is entered in the questionnaire against rules that are stored in said database; analyzing the data that has been entered into the questionnaire to determine how to filter the data regarding Social Security disability, Veteran’s Disability Compensation, or Workers Compensation claims; comparing answers received against a shared database with pre-configured data, by the computer device to determine how to proceed with the data received on the questionnaire; and filtering at least a portion of the answers into a database within the computer based on rules programmed in the computer application or defined in the shared database.

“2. The systematic method of claim 1 including the step of determining whether a specialized representative or law firm should assist a claimant in applying for benefits by to receive Social Security disability benefits, Veteran’s Disability Compensation benefits, or Workers Compensation claims benefits.

“3. The systematic method of claim 1 wherein said questionnaire includes assessing medical, financial, educational, work, and personal history to a processing stage to verify medical, financial and claim status qualifiers.

“4. The systematic method of claim 1 including the step of machine learning through identification of filtered information data for automatically updating said database in real time, subject to user confirmation, with adjusted filtered conditions.

“5. The systematic method of claim 1 including the step of populating representation forms based on the type of case, pending claim status, claim progression, client location, work flow, medical conditions, prescriptions, age, date last insured, onset date, work history, military occupational specialty and financial information.

“6. The systematic method of claim 1 wherein said questionnaire includes the service track for a veteran, the veteran’s military service, military occupational specialty, and medals.

“7. The systematic method of claim 6 wherein the gathering of information to determine eligibility for Veterans Disability includes the military branch in which the claimant served, dates of service, the position held while in service, whether or not the claimant was discharged honorably, medals received, military pension, and determining whether the claimant needs to file an application or appeal.

“8. The systematic method of claim 1 including the step of determining, by the application executing on the processor of the computer device, whether the claimant’s children appear to be eligible for receiving benefits.

“9. The systematic method of claim 1 including the step of predicting, by the application executing on the processor of the computer device, whether an application or appeal for the claimant is required, or whether the claimant has ever filed an application.”

For more information, see this patent application: LaVan, Kenneth L. Claim And Progression Management. Filed November 19, 2019 and posted March 19, 2020. Patent URL: http://appft.uspto.gov/netacgi/nph-Parser?Sect1=PTO1&Sect2=HITOFF&d=PG01&p=1&u=%2Fnetahtml%2FPTO%2Fsrchnum.html&r=1&f=G&l=50&s1=%2220200090292%22.PGNR.&OS=DN/20200090292&RS=DN/20200090292

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